The Invented Bedtime Story: HPV Vaccines and Risky Teen Sex
When the initial HPV (human papillomavirus) vaccine was released in 2006, it was met with a huge public outcry in the United States from concerned parents, pediatricians, and politicians. Their claim was that vaccinating preadolescent girls and boys would encourage more risky adolescent sexual behavior.
The idea was that the vaccine would give young adults a false sense of protective security and thus encourage them to engage in riskier sexual activities (sex without a condom, increased number of partners, etc.). Researchers immediately began structuring studies that would investigate the claim, and several studies were launched across the country.
The research conclusions were that there was no evidence to suggest a link in riskier adolescent sexual behaviors among vaccinated adolescents. Despite the clinical evidence, the idea of mandatory HPV vaccinations has sparked a lot of controversy across the country. Reasons favorably cited for adult opposition were that it was not necessary for their child or that their child was not sexually active. Physicians have also expressed concern about discussing sexual activity and behavior with preadolescent patients.
Abstinence remains the predominantly taught form of sex education in the United States. HPV is transmitted predominantly through sexual contact, which means that vaccinating preadolescent girls means recognizing the potential for sexual activity in preadolescents and young adolescents at the legislative level. For many parents, politicians, and doctors, this creates uncomfortable emotional responses and has led to a push within the United States to defer the recommended age of vaccination to sometime in the teen years.
The concept of mandatory HPV vaccinations is not revolutionary: Western European countries, the United Kingdom, Canada, and Australia have since incorporated HPV vaccines into mandatory school immunization schedules. The HPV vaccine is unique in that it is one of the few known drugs that directly reduces the risk of specific cancers.
In the early 20th century, cervical cancer was the leading cause of cancer-related death among American women. With the introduction of regular Pap tests and an understanding of the HPV virus, cervical cancer now affects approximately 12,000 women a year and causes approximately 4,000 deaths a year.
In general, the issue of cervical cancer is very different. It is the second most common cause of cancer-related death among women and disproportionately affects women of childbearing age. Sadly, more than 80% of all cervical cancer cases occur in the developing world and more than 300,000 women die each year and thousands more are affected financially, socially and emotionally.
For the first time in human history we have the opportunity to reduce the risk of a specific type of cancer for our children and young people. As health care providers and citizens of the world, it is our responsibility to work to minimize barriers to access to these types of vaccines.